An anxious reader contacted Senator M. Michael Rounds’s office recently and asked what in the Republican health care plan would prevent insurers from saying to customers with pre-existing conditions, Sure, you can buy coverage from us, but we’re going to charge you an arm, leg, and liver more than folks without pre-exsiting conditions?
The question is apt, since 25% of South Dakotans under age 65 have pre-existing conditions that would have made them uninsurable on the individual market prior to the Affordable Care Act.
The Senate bill does improve on the House bill that Rep. Kristi Noem voted for by keeping the community rating requirement, the Obamacare provision that prohibits insurers from charging people higher premiums based on health status.
Senator Rounds nods toward this provision in his response to my reader’s call (with my emphasis added to the salient response on pre-existing conditions):
Thank you for contacting me about the plan to replace the Affordable Care Act (ACA), commonly known as Obamacare. I appreciate hearing from you.
I, along with others, encouraged Senate Majority Leader Mitch McConnell (R-KY) to delay a planned vote on the Better Care Reconciliation Act (BCRA). I believe there are opportunities to make the bill better. As discussions continue on the BCRA there are provisions I am working to amend that would help make coverage better, more affordable and more accessible to more Americans.
South Dakotans have reached out to me with concerns about the BCRA. In particular, many have expressed fears of losing coverage due to pre-existing conditions as well as concerns about perceived cuts to Medicaid. Even under the current BCRA proposal, Medicaid payments will continue to increase, just at a slower rate than under the ACA, making the program more sustainable for future generations. Further, under the proposed Medicaid changes, states like South Dakota would actually fair slightly better than under current law over the next few years. Also, no one with pre-existing conditions can be denied access to insurance as long as they maintain continuous coverage.
As you know, health care accounts for approximately 18 percent of our nation’s gross domestic product. In the coming weeks, the Senate will continue consideration of improvements within the proposal. With Obamacare premiums having already risen 124 percent in just the last four years, doing nothing is simply not an option. We believe it is important that innovation be allowed back into the marketplace and competition be encouraged. South Dakota families want both assurances that health care coverage is available and they want to know they can afford to protect their families.
Again, thank you for contacting me; hearing from you is important to me.
Sincerely,
Mike Rounds
United States Senator
[emphasis mine; letter to South Dakota constituent, July 2017]
It’s interesting that Rounds predicates access to coverage on maintaining continuous coverage. One of the items Rounds hates most about the ACA is the individual mandate, requiring people to buy “costly insurance plans that aren’t a good fit for them or their families.” Yet here he advocates a practical mandate on folks with pre-existing conditions. Which is it, Mike: do you want to force people to buy insurance or not?
But watch out: Rounds’s colleague Senator Ted Cruz has offered an amendment to the Senate bill that would allow an insurer to offer policies that don’t comply with ACA protections like those for folks with pre-existing conditions as long as the insurer offers at least one ACA-compliant policy. That Cruz amendment would make access a weasel word:
Cruz’s proposal makes some political sense: Moderates can say protections for those with preexisting conditions are being maintained, while conservatives can claim they’ve freed consumers from the tyranny of government regulation.
In policy terms, however, it’s just the abolition of protection for many with preexisting conditions by other means. The severely ill wouldn’t be denied access to the insurance market, but only in the sense that they are not, currently, denied access to Lamborghini dealerships.
Under Cruz’s model, many healthy consumers would avoid shelling out for high-cost, comprehensive plans. This would then make the pool of people willing to pay for such coverage disproportionately sick, which would cause the price of such plans to rise, which would make the pool even sicker, which cause prices to premiums to rise further, which would make the pool sicker still, on and on, in a death spiral, until the sick were priced out of the market completely [Eric Levitz, “Ted Cruz Has a Proposal That Just Might Save Trumpcare,” New York Magazine, 2017.06.29].
Senator Chuck Grassley recognizes the Cruz amendment as “subterfuge to get around pre-existing conditions.” Let’s hope Senator Rounds shares that recognition and prevents the Cruz amendment from gutting pre-existing condition protections. Better yet, let’s hope Senator Rounds comes to his senses and realizes that not one proposal from his party this year has promised to “make coverage better, more affordable and more accessible” than the Affordable Care Act is doing right now.
Vice President Joe Biden tells the cult to go ahead, destroy the ACA/Obamacare and see what happens next. Biden knows full well what will happen, a complete collapse of the healthcare industry, including all that work in it. Biden knows this because he was a part of why ACA/Obamacare came into play to save this country from that fate. Look at the history of premium increases before ACA/Obamacare came into play, that tells the tale. The facts are stubborn things but the main one in this all is that before the ACA/Obamacare, the system was unsustainable. Rounds is clear on this as are many in the Senate chamber, they are between a rock and a dummy.
Rounds is clear about something else as well, ACA/Obamacare is good business and has been a great situation for the company he headed and will go back to. 140% increase because of Obamacare? please, we are 7 years into the plan. Go back prior to enactment of the ACA/Obamacare and see how quickly the rates were rising with no ends in sight.
Jobs Jobs Jobs with the biggest leader, healthcare. That is the current report.
“In June, the largest gains were seen in the health-care sector, which added 37,000 jobs as an aging U.S. population continued to drive the industry. The ranks of day-care providers, financial analysts and miners also swelled last month.
Yet the numbers were disappointing on workers’ wages, which stayed flat despite the job increases. Average hourly earnings were up by 2.5 percent from a year ago to $26.25, continuing a streak of relatively weak wage growth. That may seem somewhat contradictory, since employers have been trading anecdotes of the trouble they’ve had finding qualified employees, said Cathy Barrera, chief economic adviser for ZipRecruiter, a jobs site.”
So, as Joe Biden says, proceed cult republicans, wreck the economy so we can have another bailout which is something cult republicans are damn good at. See how that plays out in 18 and 20 and beyond.
As Cory said on the podcast, (paraphrased) Sen Cruz, we’ll support your plan that allows insurance companies to sell policies without any of the Obamacare regulations if all USA citizens are able to buy into Medicare for a means tested, CBO verified, non-profit rate with written guarantees of Medicare continuity, current applications and regulations.
See? We liberals are willing to compromise. Work with us or fight amongst yourselves and let the voters decide.
C’mon guys, wingnuts had to know their idea of taxcuts for the wealthy was not going to fly with their constituents. How stoopid must a pol be to imagine they could sneak 20 plus million thrown of insurance past their constituents? If a wingnut has an idea, grab your safety net because it is about to get harpooned big time so them poor little billionaires can become trillionaires.
Could it be, Mike from Iowa, that McConnell actually tied healthcare with tax cuts knowing it would fail? Then he can claim he tried to fix both but no one would back him including his own party!
Porter, just to refresh your memory on the public option. https://www.youtube.com/watch?v=hZ5tj4cN9Jk
So what about that debt thingy? Could it be that the cult republicans are going to raise taxes on the wealthy instead of lowering them to help erase the 20 trillion in debt we are now in??? Could it be?? Naw
I believe the 25% under 65 is low
Lucy wescott (apology if
Spelling isn’t correct study claims SD is
2nd highest state for rapes. If it is written rape will be pre existing I would believe this would increase the percentage as well as other written definitions. The point is there is absolutely no protection for caps on
Costs. Are our
Costs high now? No I feel
They are affordable for the technology care we get..,,, especially with a
Pre existing condition. Everyone needs to make some
Noise here and voice concerns
Refreshing, Jerry. National healthcare came to Europe because most every hospital and doctors office and insurance company was demolished in World War II. It works so much cheaper, they kept it. Does USA have to be demolished to change? “You don’t have to be a weatherman to know which way the wind blows.”
So if rape is going to be a pre-existing condition will the criminal statute of limitations be removed? I was wondering if health coverage and the health care system would work better for patients if it were regulated similar to the public utility industries?
I think it would, Francis.
FRancis and Porter
If you mean statute for rape for repercussion for someone to press charges, no (my money on it), as you remember MR passed cap years on religious entities etc etc, and as you know includes rape along with sexual assault etc.
SD courts do like to be busy with rape and domestic violence they are too busy with other things (sarcasm)
My interpretations it can also be up to insurance companies to decide pre existing, under Obamacare majority is must be diagnosed by physician So if you go in for what you think is a cold and it’s lung cancer a year later guess what? I know this is exaggerated but read the drumpcare yourself and ask questions……this could be a ugly reality but hey guess what there will be cheap premiums ! Bit possibly no coverage
Porter, I believe that was a part of the Marshall Plan. I know in Japan, it was brought about by demanding equal rights for women there to include heath care to an already existing system. America likes to say that we nation build, and that is very true to the countries we destroy. So you may have something there Porter.
Australia does not think we can do anything remotely great again like the red hats say. https://twitter.com/InsidersABC So this trumpcare will probably be like the rest of the business ventures this poor excuse for a businessman has run into the ground.
Some very insightful folks in this group.
Jerry makes a good point that healthcare was in deep doo-doo when it became necessary for Obama care. I remember the stories of disoriented patients in hospital gowns found wandering the streets. The growing numbers of uninsured and riders for everything if you were insured.
Our former optometrist had good ideas on healthcare. She thought the education of doctors and nurses ought to be payed for by the government and that we should open the borders to FREE trade in the drug industry.
I think that would do a lot for affordable healthcare.
I really miss Moyer’s. Or for that matter a PBS that wasn’t afraid of being de-funded. I rarely tune it in now and definitely don’t contribute anymore.
All this fuss may be for naught… or this fuss may be producing the result we want. Senator John McCain Faced the Nation this morning and said of the GOP health care bill, “I think my view is it’s probably going to be dead.”
A lot of qualifiers there (plus you don’t need to “think” that your “view” is something—that’s redundant). But it’s nice to hear moderate Republicans admitting the truth.
T
So Marion had laws passed creating restrictions on when a person must sue. Can those be changed? My thought is not only can they, they must be changed.
FRancis
Attorneys out there correct me, I’m a bit rusty
No limit on class ABC felonies 23a43-1 however 7 year on many others In 2010 MR signed billed a business such as a church school etc cannot be sued and be accountable for anyone’s under their employ who may have violated anyone regardless of the class and felony. My argument at the time was the I institution had an obligation to ensur safety and trust, thus their position created a sense of trust for the person harmed. He signed 1104 in 2010 (if I remember it was HB 1104) My apologies for stating there are caps on all which there isn’t, however social caps, legal costs and personal blame also limits any reporting and the further one waits the more difficult it is to prosecute
Rounds and crowd are full of lies and misinformation regarding so many things. Here is the senate version of how veterans will get screwed by Round/Thune. Veterans right now do not have such a bad deal regarding ACA/Obamacare.
“Republicans would reverse that trend. Tester and his Democratic colleagues said the Senate bill could:
1. Result in nearly 1.75 million disabled and low-income veterans losing Medicaid coverage
2. Impose a tax on 600,000 veterans, forcing them to pay up to five times more for health insurance
3. Cause more than 5 million veterans difficulty in finding services at rural hospitals
4. Generate increased mental health-care fees for the many veterans who suffer post-traumatic stress from the wars in Iraq, Afghanistan and Vietnam
5. Result in up to 7 million veterans losing tax credits to help pay for medical care
6. Cause about 7 percent of veterans to lose access to care for opioid or other substance abuse problems.”
Why do veterans think cult republicans give a damn about us is beyond me. Cult republicans have consistently shown beyond doubt flapping the flag with one hand while jamming the shiv in with the other, all for their bottom line. This trumpcare will be devastating for everyone, but for those who served this country, beyond the pale of promises made.
On top of NOem’s lies about the failure of ACA/Obamacare, facts overrule her…again. http://www.latimes.com/business/hiltzik/la-fi-hiltzik-cms-risk-report-20170703-story,amp.html
NOem does not qualify for being a dogcatcher in Polo and neither does her opponent Jackley, both frauds of a feather.
Remember waaaay back when there was a thing called integrity in the respect for the vote? Now we are engaged with treason from the top on down. We had a great country once, can we remove this cancer and start again? http://articles.latimes.com/2000/sep/14/news/mn-20941
http://wvmetronews.com/2017/07/09/bernie-sanders-and-supporters-rally-in-morgantown-against-trump-care/
Bernie Sanders visited West Virginia to fight against TrumpCare. In essence he is trying to make a plea to Sen. Capito (R) to vote against the Republican ACA replacement bills.
Sen. Capito has voted for many repeal bills, but has expressed concern over how the Trump replacement would address the opioid crisis in Appalachia.
http://wvmetronews.com/2017/06/28/capito-aca-replacement-has-to-be-the-right-bill/
Good links doc, the dog has caught the car and is now perplexed on finding it to be friendly to it.
Of interest also is that Appalachian Power has plans to go half coal and half on other forms of energy by 2031. Not clear how much of that would be renewables and how much would be natural gas though. Probably you are talking more natural gas and some wind.
http://wvmetronews.com/2017/07/10/appalachian-power-to-rely-half-on-coal-half-on-renewable-energy/
Apparently, they want to attract more companies to WV, but said companies often have mandates from their board of directors regarding how much clean energy they purchase, and that is dictating where companies will consider locating.
Doc, as an educated feller, what do you make of cult republicans views on higher education like college? http://www.people-press.org/2017/07/10/sharp-partisan-divisions-in-views-of-national-institutions/ How can we resolve health issues of those of us who get sick without having someone go to school for it? Are we gonna go back to leeching?
The Pew Research Center poll finds 58 percent of Republicans and Republican-leaning independents think colleges and universities hurt the country.
Just 36 percent of Republicans think they have a positive effect. http://thehill.com/homenews/news/341305-poll-most-republicans-say-colleges-have-negative-impact-on-us
I respect the Doc but not his party
Generally speaking, investments in higher education provide a good return on said investment.
The product is the well-rounded individual that can listen to others, work with others, and solve problems. All political parties should be interested in all three items, particularly in an economy that needs more innovation. But if you want something more material, look at the economic impact that universities have upon the towns that host them.
I think we offer students a lot of bang for their buck. Our degrees have gone down from 128 hours to 120 hours (unless some kind of accreditation is involved). In the College of Arts and Sciences, we require a minor in a different field in addition to all of the gen ed courses to diversify that portfolio. In Physics we actively encourage both undergraduate research projects as well as internships or co-ops with companies, and I don’t know of any major that isn’t pushing “experiential learning” of some sort.
And Physics courses are robust and challenging. If you want more efficiency, Physics shares the delivery of most of its advanced coursework by distance education among SDSMT, USD, and SDSU.
So I would say as more people engage our undergraduates in either research or internships, or hire them, the value of the education they are receiving will only increase. Companies are finding out that the Physics degree provides a valuable analytical toolkit.
Leslie….which party is that?
Hear, hear, Professor